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Portal Vein Embolisation — SCE Medical Oncology MCQ

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ModerateGI CancersPortal Vein EmbolisationSCE Medical Oncology

A 60-year-old man with CRC liver metastases undergoes portal vein embolisation (PVE) before planned right hepatectomy. What is the purpose?

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Correct answer: D — To induce compensatory hypertrophy of the future liver remnant (FLR)

Portal vein embolisation hypertrophies the FLR by redirecting portal blood flow. When the planned FLR is insufficient (<20-30% for normal liver, <30-40% after chemotherapy), PVE is performed 4-6 weeks pre-operatively. CT volumetry before and after PVE confirms adequate hypertrophy (typically >5% absolute increase or >20% relative increase). If hypertrophy is inadequate, ALPPS (Associating Liver Partition and Portal vein Ligation for Staged hepatectomy) is a more aggressive alternative achieving faster hypertrophy (1-2 weeks) but with higher morbidity.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer